Treatment of early diffuse cutaneous systemic sclerosis patients in Japan by low-dose corticosteroids for skin involvement.

Systemic sclerosis (SSc) is a multiorgan systemic disorder characterized by excessive collagen deposition. This disease is usually classified into two clinical subsets - diffuse cutaneous SSc (dSSc) and limited cutaneous SSc (lSSc). We have proposed low-dose oral corticosteroid treatment with indication criteria consisting of the following three conditions: (1) early onset; (2) edematous changes; and (3) rapid progression. Cases satisfying 2 or 3 criteria have a definite indication, while those meeting 0 or 1 criterion have no indication. We treated 23 cases of dSSc by low-dose oral corticosteroid (prednisolone 20 mg/day as the initial dosage) and evaluated the effect using the modified Rodnan total skin thickness score (m Rodnan TSS). The mean initial TSS (20.3+/-9.3) decreased significantly to 12.8+/-7.0 after one year of treatment (p < 0.005) and to 8.7+/-6.1 at final evaluation (p < 0.001). Thus, we confirmed the usefulness of oral corticosteroid treatment for early dSSc in Japanese patients.